Provider Demographics
NPI:1922111079
Name:ESSEX HEALTH CARE CORP
Entity Type:Organization
Organization Name:ESSEX HEALTH CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DANIEH
Authorized Official - Last Name:COLLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-483-5551
Mailing Address - Street 1:23 BRANFORD PLACE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102
Mailing Address - Country:US
Mailing Address - Phone:973-483-5551
Mailing Address - Fax:
Practice Address - Street 1:23 BRANFORD PLACE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102
Practice Address - Country:US
Practice Address - Phone:973-483-5551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA043533207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2524503Medicaid
D19915Medicare UPIN
NJ2524503Medicaid